~(18)F-FDG PET/CT双时相显像对结核性和肿瘤性腹膜弥漫性病变的诊断价值
|
摘要
目的结核性和肿瘤性病变引起的腹膜弥漫性病变的影像特征有许多相似之处。本研究探讨~(18)F-FDG双时相显像对两者的诊断价值。资料与方法回顾性分析85例疑似腹膜弥漫性病变患者的临床资料,均行~(18)F-FDG双时相显像。经病理和(或)临床证实59例肿瘤性、26例结核性腹膜病变。分别测定腹膜、腹腔积液早期、延迟相最大标准化摄取值(SUVmax),计算2次显像SUVmax的变化;分析两组腹膜SUVmax值及腹腔积液SUVmax值的双时相变化。结果肿瘤组延迟时相腹膜SUVmax值(14.00±5.18)显著高于早期(11.47±4.34),结核组延迟时相腹膜SUVmax值(12.61±3.97)显著高于早期(10.46±3.00),差异均有统计学意义(P<0.05)。肿瘤组延迟时相腹腔积液SUVmax值(1.92±0.37)显著高于早期(1.80±0.36),差异有统计学意义(P<0.01);结核组延迟时相SUVmax(1.64±0.36)高于早期(1.58±0.29),但差异无统计学意义(P=0.171);肿瘤组与结核组间早期和延迟相SUVmax差异均有统计学意义(P<0.05)。腹腔积液ROC曲线分析结果显示,早期相曲线下面积为0.673(95%CI 0.557～0.790,P=0.011);延迟相曲线下面积为0.709(95%CI 0.588～0.830,P=0.002)。结论腹腔积液SUVmax有助于鉴别结核性和肿瘤性腹膜病变,延迟相SUVmax具有更高的诊断价值。
Purpose There are many similarities in the imaging features of diffuse lesions of the peritoneum caused by tuberculous and neoplastic lesions. This study investigates the diagnostic value of ~(18) F-FDG dual-phase imaging. Materials and Methods The clinical data of 85 patients with suspected peritoneal diffuse lesions were retrospectively analyzed. All the patients underwent dual-time point ~(18) FFDG imaging. It was confirmed pathologically and/or clinically that 59 patients were with neoplastic and 26 patients were with tuberculous peritoneal lesions. The maximum standardized uptake value(SUVmax) of the peritoneal and abdominal ascites at both the early scan and the delayed scan were measured respectively and the change of SUVmax in the two imaging was calculated. The two-phase changes of the SUVmax value of the peritoneum and the SUVmax value of the peritoneal ascites were analyzed. Results As for the peritoneal SUVmax values, the SUVmax of the delayed scan(14.00±5.18) was higher than that of the early scan(11.47±4.34) in tumor group. The SUVmax of the delayed scan(12.61±3.97) was higher than that of the early scan(10.46±3.00) in the tuberculosis group, with statistical significance(P<0.05). As for the SUVmax of ascites, the SUVmax of the delayed scan(1.92±0.37) was obviously higher than that of the early scan(1.80±0.36) in tumor group, with the difference being statistically significant(P<0.01). The SUVmax of the delayed scan(1.64±0.36) was higher than that of the early scan(1.58±0.29) in the tuberculosis group, but the difference was of no statistical significance(P=0.171). There was significant difference in the SUVmax between tumor group and tuberculosis group in both early scan and delayed scan(P<0.05). The results of ROC curve analysis of ascites showed that the area under the curve was 0.673(95% CI 0.557-0.790, P=0.011) and the area under the curve was 0.709(95% CI 0.588-0.830, P=0.002). Conclusion The peritoneal effusion SUVmax helps to identify tuberculous and neoplastic peritoneal lesions and the SUVmax of the delayed scan is of a higher diagnostic value.
Purpose There are many similarities in the imaging features of diffuse lesions of the peritoneum caused by tuberculous and neoplastic lesions. This study investigates the diagnostic value of ~(18) F-FDG dual-phase imaging. Materials and Methods The clinical data of 85 patients with suspected peritoneal diffuse lesions were retrospectively analyzed. All the patients underwent dual-time point ~(18) FFDG imaging. It was confirmed pathologically and/or clinically that 59 patients were with neoplastic and 26 patients were with tuberculous peritoneal lesions. The maximum standardized uptake value(SUVmax) of the peritoneal and abdominal ascites at both the early scan and the delayed scan were measured respectively and the change of SUVmax in the two imaging was calculated. The two-phase changes of the SUVmax value of the peritoneum and the SUVmax value of the peritoneal ascites were analyzed. Results As for the peritoneal SUVmax values, the SUVmax of the delayed scan(14.00±5.18) was higher than that of the early scan(11.47±4.34) in tumor group. The SUVmax of the delayed scan(12.61±3.97) was higher than that of the early scan(10.46±3.00) in the tuberculosis group, with statistical significance(P<0.05). As for the SUVmax of ascites, the SUVmax of the delayed scan(1.92±0.37) was obviously higher than that of the early scan(1.80±0.36) in tumor group, with the difference being statistically significant(P<0.01). The SUVmax of the delayed scan(1.64±0.36) was higher than that of the early scan(1.58±0.29) in the tuberculosis group, but the difference was of no statistical significance(P=0.171). There was significant difference in the SUVmax between tumor group and tuberculosis group in both early scan and delayed scan(P<0.05). The results of ROC curve analysis of ascites showed that the area under the curve was 0.673(95% CI 0.557-0.790, P=0.011) and the area under the curve was 0.709(95% CI 0.588-0.830, P=0.002). Conclusion The peritoneal effusion SUVmax helps to identify tuberculous and neoplastic peritoneal lesions and the SUVmax of the delayed scan is of a higher diagnostic value.
引文
[1]De Andrade JP,Mezhir JJ.The critical role of peritoneal cytology in the staging of gastric cancer:an evidence-based review.J Surg Oncol,2014,110(3):291-297.
[2]王颖,尹雅芙,李娜,等.PET/CT在腹膜病变诊断中的临床应用价值.中国普通外科杂志,2013,22(3):363-367.
[3]刘小婷.18F-FDG PET/CT对不明原因发热的诊断价值.中国医学影像学杂志,2017,25(3):231-234.
[4]Treglia G,Sadeghi R,Annunziata SA,et al.Diagnostic performance of fluorine-18-fluorodeoxyglucose positron emission tomography in the assessment of pleural abnormalities in cancer patients:a systematic review and a meta-analysis.Lung Cancer,2014,83(1):1-7.
[5]马文超,陈薇,付蔷,等.腹膜弥漫性病变的18F-FDGPET/CT诊断辨析.国际放射医学核医学杂志,2018,42(2):192-195.
[6]Saaiq M,Shah SA,Zubair M.Abdominal tuberculosis:epidemiologic profile and management experience of 233cases.J Pak Med Assoc,2012,62(7):704-707.
[7]李现军,李凤歧,韩建奎,等.18F-FDG PET/CT检查中腹腔积液SUV对不明原因腹腔积液的辅助诊断价值.中华核医学与分子影像学杂志,2013,33(6):421-425.
[8]尹亮,黄世明,林志春,等.结核性与肿瘤性腹膜弥漫性病变的18F-FDG PET/CT影像特征比较.武警医学,2017,28(2):182-185.
[9]尹亮,林志春,岳建兰,等.结核性与肿瘤性腹膜弥漫性病变的18F-FDG PET/CT鉴别诊断价值.中华肿瘤防治杂志,2016,23(16):1104-1108.
[10]Yin WJ,Zheng GQ,Chen YF,et al.CT differentiation of malignant peritoneal mesothelioma and tuberculous peritonitis.Radiol Med,2016,121(4):253-260.
[11]张蓉琴,李向东,王欣璐,等.18F-FDG PET/CT显像诊断不明显原因腹腔积液.中国医学影像技术,2016,32(1):79-82.
[12]Meller J,Sahlmann CO,Scheel AK.18F-FDG PET and PET/CT in fever of unknown origin.J Nucl Med,2007,48:35-45.
[13]郑冬,牛力璇,田嘉禾,等.18F-FDG PET/CT最大标准化摄取值与舌鳞状细胞癌临床特征的关系.中国医学影像学杂志,2017,25(7):481-486.
[14]Lodge MA,Lucas JD,Marsen PK,et al.A PET study of FDGuptake in soft tissue mass.Eur J Nucl Med,1999,26:22-30.
[2]王颖,尹雅芙,李娜,等.PET/CT在腹膜病变诊断中的临床应用价值.中国普通外科杂志,2013,22(3):363-367.
[3]刘小婷.18F-FDG PET/CT对不明原因发热的诊断价值.中国医学影像学杂志,2017,25(3):231-234.
[4]Treglia G,Sadeghi R,Annunziata SA,et al.Diagnostic performance of fluorine-18-fluorodeoxyglucose positron emission tomography in the assessment of pleural abnormalities in cancer patients:a systematic review and a meta-analysis.Lung Cancer,2014,83(1):1-7.
[5]马文超,陈薇,付蔷,等.腹膜弥漫性病变的18F-FDGPET/CT诊断辨析.国际放射医学核医学杂志,2018,42(2):192-195.
[6]Saaiq M,Shah SA,Zubair M.Abdominal tuberculosis:epidemiologic profile and management experience of 233cases.J Pak Med Assoc,2012,62(7):704-707.
[7]李现军,李凤歧,韩建奎,等.18F-FDG PET/CT检查中腹腔积液SUV对不明原因腹腔积液的辅助诊断价值.中华核医学与分子影像学杂志,2013,33(6):421-425.
[8]尹亮,黄世明,林志春,等.结核性与肿瘤性腹膜弥漫性病变的18F-FDG PET/CT影像特征比较.武警医学,2017,28(2):182-185.
[9]尹亮,林志春,岳建兰,等.结核性与肿瘤性腹膜弥漫性病变的18F-FDG PET/CT鉴别诊断价值.中华肿瘤防治杂志,2016,23(16):1104-1108.
[10]Yin WJ,Zheng GQ,Chen YF,et al.CT differentiation of malignant peritoneal mesothelioma and tuberculous peritonitis.Radiol Med,2016,121(4):253-260.
[11]张蓉琴,李向东,王欣璐,等.18F-FDG PET/CT显像诊断不明显原因腹腔积液.中国医学影像技术,2016,32(1):79-82.
[12]Meller J,Sahlmann CO,Scheel AK.18F-FDG PET and PET/CT in fever of unknown origin.J Nucl Med,2007,48:35-45.
[13]郑冬,牛力璇,田嘉禾,等.18F-FDG PET/CT最大标准化摄取值与舌鳞状细胞癌临床特征的关系.中国医学影像学杂志,2017,25(7):481-486.
[14]Lodge MA,Lucas JD,Marsen PK,et al.A PET study of FDGuptake in soft tissue mass.Eur J Nucl Med,1999,26:22-30.